{"id":274,"date":"2019-10-23T22:11:40","date_gmt":"2019-10-23T22:11:40","guid":{"rendered":"https:\/\/onewishfoundation.org\/owf\/?page_id=274"},"modified":"2019-10-24T00:53:57","modified_gmt":"2019-10-24T00:53:57","slug":"childrens-application","status":"publish","type":"page","link":"https:\/\/onewishfoundation.org\/owf\/childrens-application\/","title":{"rendered":"Children&#8217;s Application"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row full_width=&#8221;stretch_row&#8221; bg_type=&#8221;bg_color&#8221; css=&#8221;.vc_custom_1571878420218{margin-top: -70px !important;}&#8221; bg_color_value=&#8221;#def4d5&#8243;][vc_column][vc_column_text]<span style=\"font-size: 14pt;\"><strong>Eligibility Requirements:<\/strong> Children ages 6-18 yrs., U.S. Citizen, with life-altering medical or social conditions, No previous grants for outdoor adventures. Depending on the individual wish \u2013 local sporting regulations will apply. Age exceptions may be made to accommodate injured U.S. military personnel\/veterans. Please fill out the application in it\u2019s entirety.<\/span><br \/>\n<span style=\"font-size: 14pt;\">Form must be signed by parent or legal guardian.<\/span>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]<div class=\"wpforms-container wpforms-container-full\" id=\"wpforms-280\"><form id=\"wpforms-form-280\" class=\"wpforms-validate wpforms-form\" data-formid=\"280\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/owf\/wp-json\/wp\/v2\/pages\/274\" data-token=\"71fcc5904067a803c5ad9c2093315bcd\" data-token-time=\"1777463570\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-280-field_41-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"41\"><h3 id=\"wpforms-280-field_41\">CHILD&#039;S PERSONAL INFORMATION<\/h3><\/div><div id=\"wpforms-280-field_1-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half wpforms-first\" data-field-id=\"1\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_1\">First Name<\/label><input type=\"text\" id=\"wpforms-280-field_1\" class=\"wpforms-field-large\" name=\"wpforms[fields][1]\" ><\/div><div id=\"wpforms-280-field_2-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half\" data-field-id=\"2\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_2\">Last Name<\/label><input type=\"text\" id=\"wpforms-280-field_2\" class=\"wpforms-field-large\" name=\"wpforms[fields][2]\" ><\/div><div id=\"wpforms-280-field_3-container\" class=\"wpforms-field wpforms-field-text wpforms-one-third wpforms-first\" data-field-id=\"3\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_3\">Child prefers to be called (nickname)<\/label><input type=\"text\" id=\"wpforms-280-field_3\" class=\"wpforms-field-large\" name=\"wpforms[fields][3]\" ><\/div><div id=\"wpforms-280-field_4-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half wpforms-one-third\" data-field-id=\"4\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_4\">Date of Birth<\/label><input type=\"text\" id=\"wpforms-280-field_4\" class=\"wpforms-field-large\" name=\"wpforms[fields][4]\" ><\/div><div id=\"wpforms-280-field_5-container\" class=\"wpforms-field wpforms-field-text wpforms-one-third\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_5\">Last 4 digits of S.S.#<\/label><input type=\"text\" id=\"wpforms-280-field_5\" class=\"wpforms-field-large\" name=\"wpforms[fields][5]\" ><\/div><div id=\"wpforms-280-field_6-container\" class=\"wpforms-field wpforms-field-text wpforms-one-fourth wpforms-first\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_6\">Gender (male, female)<\/label><input type=\"text\" id=\"wpforms-280-field_6\" class=\"wpforms-field-large\" name=\"wpforms[fields][6]\" ><\/div><div id=\"wpforms-280-field_7-container\" class=\"wpforms-field wpforms-field-text wpforms-one-fourth\" data-field-id=\"7\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_7\">Height<\/label><input type=\"text\" id=\"wpforms-280-field_7\" class=\"wpforms-field-large\" name=\"wpforms[fields][7]\" ><\/div><div id=\"wpforms-280-field_8-container\" class=\"wpforms-field wpforms-field-text wpforms-one-fourth\" data-field-id=\"8\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_8\">Weight<\/label><input type=\"text\" id=\"wpforms-280-field_8\" class=\"wpforms-field-large\" name=\"wpforms[fields][8]\" ><\/div><div id=\"wpforms-280-field_9-container\" class=\"wpforms-field wpforms-field-text wpforms-one-fourth\" data-field-id=\"9\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_9\">Eye Color<\/label><input type=\"text\" id=\"wpforms-280-field_9\" class=\"wpforms-field-large\" name=\"wpforms[fields][9]\" ><\/div><div id=\"wpforms-280-field_10-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"10\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_10\">Shirt Size<\/label><input type=\"text\" id=\"wpforms-280-field_10\" class=\"wpforms-field-large\" name=\"wpforms[fields][10]\" ><\/div><div id=\"wpforms-280-field_11-container\" class=\"wpforms-field wpforms-field-text wpforms-one-fourth wpforms-first\" data-field-id=\"11\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_11\">Pants Size<\/label><input type=\"text\" id=\"wpforms-280-field_11\" class=\"wpforms-field-large\" name=\"wpforms[fields][11]\" ><\/div><div id=\"wpforms-280-field_12-container\" class=\"wpforms-field wpforms-field-text wpforms-one-fourth\" data-field-id=\"12\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_12\">Shoe Size<\/label><input type=\"text\" id=\"wpforms-280-field_12\" class=\"wpforms-field-large\" name=\"wpforms[fields][12]\" ><\/div><div id=\"wpforms-280-field_14-container\" class=\"wpforms-field wpforms-field-text wpforms-one-fourth\" data-field-id=\"14\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_14\">Right or Left Handed<\/label><input type=\"text\" id=\"wpforms-280-field_14\" class=\"wpforms-field-large\" name=\"wpforms[fields][14]\" ><\/div><div id=\"wpforms-280-field_16-container\" class=\"wpforms-field wpforms-field-select wpforms-one-third wpforms-first wpforms-field-select-style-classic\" data-field-id=\"16\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_16\">Race<\/label><select id=\"wpforms-280-field_16\" class=\"wpforms-field-large\" name=\"wpforms[fields][16]\"><option value=\"Choose one ( Click here )\"  class=\"choice-6 depth-1\"  >Choose one ( Click here )<\/option><option value=\"African American\"  class=\"choice-1 depth-1\"  >African American<\/option><option value=\"Caucasian\"  class=\"choice-2 depth-1\"  >Caucasian<\/option><option value=\"Hispanic\"  class=\"choice-3 depth-1\"  >Hispanic<\/option><option value=\"Native American\"  class=\"choice-4 depth-1\"  >Native American<\/option><option value=\"Other\"  class=\"choice-5 depth-1\"  >Other<\/option><\/select><\/div><div id=\"wpforms-280-field_17-container\" class=\"wpforms-field wpforms-field-select wpforms-one-third wpforms-field-select-style-classic\" data-field-id=\"17\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_17\">U.S. Military<\/label><select id=\"wpforms-280-field_17\" class=\"wpforms-field-medium\" name=\"wpforms[fields][17]\"><option value=\"Choose one ( Click here )\"  class=\"choice-4 depth-1\"  >Choose one ( Click here )<\/option><option value=\"Yes\"  class=\"choice-1 depth-1\"  >Yes<\/option><option value=\"No\"  class=\"choice-2 depth-1\"  >No<\/option><\/select><\/div><div id=\"wpforms-280-field_18-container\" class=\"wpforms-field wpforms-field-text wpforms-one-third\" data-field-id=\"18\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_18\">If yes what branch<\/label><input type=\"text\" id=\"wpforms-280-field_18\" class=\"wpforms-field-large\" name=\"wpforms[fields][18]\" ><\/div><div id=\"wpforms-280-field_20-container\" class=\"wpforms-field wpforms-field-select wpforms-one-half wpforms-first wpforms-field-select-style-classic\" data-field-id=\"20\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_20\">Does the child have a website dedicated to his\/her medical condition<\/label><select id=\"wpforms-280-field_20\" class=\"wpforms-field-large\" name=\"wpforms[fields][20]\"><option value=\"Choose one ( Click here )\"  class=\"choice-1 depth-1\"  >Choose one ( Click here )<\/option><option value=\"Yes\"  class=\"choice-2 depth-1\"  >Yes<\/option><option value=\"No\"  class=\"choice-3 depth-1\"  >No<\/option><\/select><\/div><div id=\"wpforms-280-field_21-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half\" data-field-id=\"21\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_21\">Web Address<\/label><input type=\"text\" id=\"wpforms-280-field_21\" class=\"wpforms-field-large\" name=\"wpforms[fields][21]\" ><\/div><div id=\"wpforms-280-field_23-container\" class=\"wpforms-field wpforms-field-textarea wpforms-one-half wpforms-first\" data-field-id=\"23\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_23\">Please provide brief description of childs life-altering medical or social condition<\/label><textarea id=\"wpforms-280-field_23\" class=\"wpforms-field-medium\" name=\"wpforms[fields][23]\" ><\/textarea><\/div><div id=\"wpforms-280-field_24-container\" class=\"wpforms-field wpforms-field-textarea wpforms-one-half\" data-field-id=\"24\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_24\">Provide any physical limitations or special needs that need to be taken into consideration based on the child\u2019s wish<\/label><textarea id=\"wpforms-280-field_24\" class=\"wpforms-field-medium\" name=\"wpforms[fields][24]\" ><\/textarea><\/div><div id=\"wpforms-280-field_25-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"25\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_25\">Current Treatments needed that may limit child\u2019s availability for a granted wish (please include frequency of treatments &amp; when the next treatment is scheduled)<\/label><textarea id=\"wpforms-280-field_25\" class=\"wpforms-field-medium\" name=\"wpforms[fields][25]\" ><\/textarea><\/div><div id=\"wpforms-280-field_26-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half wpforms-first\" data-field-id=\"26\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_26\">When would child be available, if chosen, to participate in a One Wish Foundation outdoor adventure?<\/label><input type=\"text\" id=\"wpforms-280-field_26\" class=\"wpforms-field-medium\" name=\"wpforms[fields][26]\" ><\/div><div id=\"wpforms-280-field_28-container\" class=\"wpforms-field wpforms-field-select wpforms-one-half wpforms-field-select-style-classic\" data-field-id=\"28\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_28\">Has child ever received any type of wish \/ grant for an outdoor adventure?<\/label><select id=\"wpforms-280-field_28\" class=\"wpforms-field-medium\" name=\"wpforms[fields][28]\"><option value=\"Choose One ( Click Here )\"  class=\"choice-1 depth-1\"  >Choose One ( Click Here )<\/option><option value=\"Yes\"  class=\"choice-2 depth-1\"  >Yes<\/option><option value=\"No\"  class=\"choice-3 depth-1\"  >No<\/option><option value=\"Applied but not granted\"  class=\"choice-4 depth-1\"  >Applied but not granted<\/option><\/select><\/div><div id=\"wpforms-280-field_29-container\" class=\"wpforms-field wpforms-field-text wpforms-one-third wpforms-first\" data-field-id=\"29\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_29\">If Yes \u2013 Which organization?<\/label><input type=\"text\" id=\"wpforms-280-field_29\" class=\"wpforms-field-large\" name=\"wpforms[fields][29]\" ><\/div><div id=\"wpforms-280-field_30-container\" class=\"wpforms-field wpforms-field-text wpforms-one-third\" data-field-id=\"30\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_30\">When<\/label><input type=\"text\" id=\"wpforms-280-field_30\" class=\"wpforms-field-large\" name=\"wpforms[fields][30]\" ><\/div><div id=\"wpforms-280-field_31-container\" class=\"wpforms-field wpforms-field-text wpforms-one-third\" data-field-id=\"31\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_31\">What wish was granted or requested?<\/label><input type=\"text\" id=\"wpforms-280-field_31\" class=\"wpforms-field-large\" name=\"wpforms[fields][31]\" ><\/div><div id=\"wpforms-280-field_32-container\" class=\"wpforms-field wpforms-field-select wpforms-one-half wpforms-first wpforms-field-select-style-classic\" data-field-id=\"32\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_32\">Does child have any application in currently with any other organization?<\/label><select id=\"wpforms-280-field_32\" class=\"wpforms-field-large\" name=\"wpforms[fields][32]\"><option value=\"Choose One ( Click Here )\"  class=\"choice-1 depth-1\"  >Choose One ( Click Here )<\/option><option value=\"Yes\"  class=\"choice-2 depth-1\"  >Yes<\/option><option value=\"No\"  class=\"choice-3 depth-1\"  >No<\/option><\/select><\/div><div id=\"wpforms-280-field_33-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half\" data-field-id=\"33\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_33\">Organization<\/label><input type=\"text\" id=\"wpforms-280-field_33\" class=\"wpforms-field-large\" name=\"wpforms[fields][33]\" ><\/div><div id=\"wpforms-280-field_34-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"34\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_34\">Briefly describe the child\u2019s top three wishes<\/label><textarea id=\"wpforms-280-field_34\" class=\"wpforms-field-medium\" name=\"wpforms[fields][34]\" ><\/textarea><\/div><div id=\"wpforms-280-field_35-container\" class=\"wpforms-field wpforms-field-select wpforms-one-half wpforms-first wpforms-field-select-style-classic\" data-field-id=\"35\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_35\">If child\u2019s wishes involve a hunting \/ fishing adventure \u2013 has the child ever participated in these activities before?<\/label><select id=\"wpforms-280-field_35\" class=\"wpforms-field-medium\" name=\"wpforms[fields][35]\"><option value=\"Choose One ( Click Here )\"  class=\"choice-1 depth-1\"  >Choose One ( Click Here )<\/option><option value=\"Yes\"  class=\"choice-2 depth-1\"  >Yes<\/option><option value=\"No\"  class=\"choice-3 depth-1\"  >No<\/option><\/select><\/div><div id=\"wpforms-280-field_36-container\" class=\"wpforms-field wpforms-field-textarea wpforms-one-half\" data-field-id=\"36\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_36\">Briefly explain child\u2019s level of experience: <\/label><textarea id=\"wpforms-280-field_36\" class=\"wpforms-field-medium\" name=\"wpforms[fields][36]\" ><\/textarea><\/div><div id=\"wpforms-280-field_37-container\" class=\"wpforms-field wpforms-field-select wpforms-one-third wpforms-first wpforms-field-select-style-classic\" data-field-id=\"37\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_37\">Has child completed a regulated Hunter\u2019s Safety Course?<\/label><select id=\"wpforms-280-field_37\" class=\"wpforms-field-medium\" name=\"wpforms[fields][37]\"><option value=\"Choose One ( Click Here )\"  class=\"choice-1 depth-1\"  >Choose One ( Click Here )<\/option><option value=\"Yes\"  class=\"choice-2 depth-1\"  >Yes<\/option><option value=\"No\"  class=\"choice-3 depth-1\"  >No<\/option><\/select><\/div><div id=\"wpforms-280-field_38-container\" class=\"wpforms-field wpforms-field-text wpforms-one-third\" data-field-id=\"38\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_38\">If Yes - State<\/label><input type=\"text\" id=\"wpforms-280-field_38\" class=\"wpforms-field-large\" name=\"wpforms[fields][38]\" ><\/div><div id=\"wpforms-280-field_39-container\" class=\"wpforms-field wpforms-field-text wpforms-one-third\" data-field-id=\"39\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_39\">Certificate #<\/label><input type=\"text\" id=\"wpforms-280-field_39\" class=\"wpforms-field-large\" name=\"wpforms[fields][39]\" ><\/div><div id=\"wpforms-280-field_108-container\" class=\"wpforms-field wpforms-field-html\" data-field-id=\"108\"><div id=\"wpforms-280-field_108\"><br \/>\r\n<br \/>\r\n<hr \/><\/div><\/div><div id=\"wpforms-280-field_42-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"42\"><h3 id=\"wpforms-280-field_42\">MEDICAL VERIFICATION<\/h3><\/div><div id=\"wpforms-280-field_43-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"43\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_43\">MEDICAL VERIFICATION: Child\u2019s attending physician<\/label><input type=\"text\" id=\"wpforms-280-field_43\" class=\"wpforms-field-large\" name=\"wpforms[fields][43]\" ><\/div><div id=\"wpforms-280-field_44-container\" class=\"wpforms-field wpforms-field-address\" data-field-id=\"44\"><label class=\"wpforms-field-label\">Address<\/label><div class=\"wpforms-field-row wpforms-field-large\"><div ><input type=\"text\" id=\"wpforms-280-field_44\" class=\"wpforms-field-address-address1\" name=\"wpforms[fields][44][address1]\" ><label for=\"wpforms-280-field_44\" class=\"wpforms-field-sublabel after\">Address Line 1<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div ><input type=\"text\" id=\"wpforms-280-field_44-address2\" class=\"wpforms-field-address-address2\" name=\"wpforms[fields][44][address2]\" ><label for=\"wpforms-280-field_44-address2\" class=\"wpforms-field-sublabel after\">Address Line 2<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-280-field_44-city\" class=\"wpforms-field-address-city\" name=\"wpforms[fields][44][city]\" ><label for=\"wpforms-280-field_44-city\" class=\"wpforms-field-sublabel after\">City<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><select id=\"wpforms-280-field_44-state\" class=\"wpforms-field-address-state\" name=\"wpforms[fields][44][state]\" ><option class=\"placeholder\" value=\"\" selected disabled>Choose One ( Click Here )<\/option><option value=\"AL\" >Alabama<\/option><option value=\"AK\" >Alaska<\/option><option value=\"AZ\" >Arizona<\/option><option value=\"AR\" >Arkansas<\/option><option value=\"CA\" >California<\/option><option value=\"CO\" >Colorado<\/option><option value=\"CT\" >Connecticut<\/option><option value=\"DE\" >Delaware<\/option><option value=\"DC\" >District of Columbia<\/option><option value=\"FL\" >Florida<\/option><option value=\"GA\" >Georgia<\/option><option value=\"HI\" >Hawaii<\/option><option value=\"ID\" >Idaho<\/option><option value=\"IL\" >Illinois<\/option><option value=\"IN\" >Indiana<\/option><option value=\"IA\" >Iowa<\/option><option value=\"KS\" >Kansas<\/option><option value=\"KY\" >Kentucky<\/option><option value=\"LA\" >Louisiana<\/option><option value=\"ME\" >Maine<\/option><option value=\"MD\" >Maryland<\/option><option value=\"MA\" >Massachusetts<\/option><option value=\"MI\" >Michigan<\/option><option value=\"MN\" >Minnesota<\/option><option value=\"MS\" >Mississippi<\/option><option value=\"MO\" >Missouri<\/option><option value=\"MT\" >Montana<\/option><option value=\"NE\" >Nebraska<\/option><option value=\"NV\" >Nevada<\/option><option value=\"NH\" >New Hampshire<\/option><option value=\"NJ\" >New Jersey<\/option><option value=\"NM\" >New Mexico<\/option><option value=\"NY\" >New York<\/option><option value=\"NC\" >North Carolina<\/option><option value=\"ND\" >North Dakota<\/option><option value=\"OH\" >Ohio<\/option><option value=\"OK\" >Oklahoma<\/option><option value=\"OR\" >Oregon<\/option><option value=\"PA\" >Pennsylvania<\/option><option value=\"RI\" >Rhode Island<\/option><option value=\"SC\" >South Carolina<\/option><option value=\"SD\" >South Dakota<\/option><option value=\"TN\" >Tennessee<\/option><option value=\"TX\" >Texas<\/option><option value=\"UT\" >Utah<\/option><option value=\"VT\" >Vermont<\/option><option value=\"VA\" >Virginia<\/option><option value=\"WA\" >Washington<\/option><option value=\"WV\" >West Virginia<\/option><option value=\"WI\" >Wisconsin<\/option><option value=\"WY\" >Wyoming<\/option><\/select><label for=\"wpforms-280-field_44-state\" class=\"wpforms-field-sublabel after\">State<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-280-field_44-postal\" class=\"wpforms-field-address-postal wpforms-masked-input\" data-inputmask-mask=\"(99999)|(99999-9999)\" data-inputmask-keepstatic=\"true\" data-rule-inputmask-incomplete=\"1\" name=\"wpforms[fields][44][postal]\" ><label for=\"wpforms-280-field_44-postal\" class=\"wpforms-field-sublabel after\">Zip Code<\/label><\/div><\/div><\/div><div id=\"wpforms-280-field_45-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half wpforms-first\" data-field-id=\"45\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_45\">Phone Number<\/label><input type=\"text\" id=\"wpforms-280-field_45\" class=\"wpforms-field-large\" name=\"wpforms[fields][45]\" ><\/div><div id=\"wpforms-280-field_46-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half\" data-field-id=\"46\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_46\">Fax Number<\/label><input type=\"text\" id=\"wpforms-280-field_46\" class=\"wpforms-field-large\" name=\"wpforms[fields][46]\" ><\/div><div id=\"wpforms-280-field_47-container\" class=\"wpforms-field wpforms-field-html\" data-field-id=\"47\"><div id=\"wpforms-280-field_47\">Due to current privacy regulations, the One Wish Foundation requires the parent's \/ legal guardian\u2019s permission to contact your child\u2019s physician. Please sign below if you agree with the following statement: I hereby grant the One Wish Foundation permission to contact my child\u2019s attending physician regarding my child\u2019s medical condition. I further grant permission for the physician, listed above, to release the required information and\/or speak to the One Wish Foundation regarding my child\u2019s medical condition. If your child has more than one primary physician - please include information on an additional sheet.<\/div><\/div><div id=\"wpforms-280-field_48-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half wpforms-first\" data-field-id=\"48\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_48\">Signature of Parent or Guardian ( Type in Name )<\/label><input type=\"text\" id=\"wpforms-280-field_48\" class=\"wpforms-field-large\" name=\"wpforms[fields][48]\" ><\/div><div id=\"wpforms-280-field_49-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half\" data-field-id=\"49\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_49\">Date<\/label><input type=\"text\" id=\"wpforms-280-field_49\" class=\"wpforms-field-large\" name=\"wpforms[fields][49]\" ><\/div><div id=\"wpforms-280-field_50-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"50\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_50\">Does child receive help from a Social Worker or any other Specialists?<\/label><select id=\"wpforms-280-field_50\" class=\"wpforms-field-medium\" name=\"wpforms[fields][50]\"><option value=\"Choose One ( Click Here )\"  class=\"choice-1 depth-1\"  >Choose One ( Click Here )<\/option><option value=\"Yes\"  class=\"choice-2 depth-1\"  >Yes<\/option><option value=\"No\"  class=\"choice-3 depth-1\"  >No<\/option><\/select><\/div><div id=\"wpforms-280-field_51-container\" class=\"wpforms-field wpforms-field-html\" data-field-id=\"51\"><div id=\"wpforms-280-field_51\"> If Yes \u2013 please provide contact information below.<\/div><\/div><div id=\"wpforms-280-field_53-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half wpforms-first\" data-field-id=\"53\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_53\">Name<\/label><input type=\"text\" id=\"wpforms-280-field_53\" class=\"wpforms-field-large\" name=\"wpforms[fields][53]\" ><\/div><div id=\"wpforms-280-field_54-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half\" data-field-id=\"54\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_54\">Name of affiliation<\/label><input type=\"text\" id=\"wpforms-280-field_54\" class=\"wpforms-field-large\" name=\"wpforms[fields][54]\" ><\/div><div id=\"wpforms-280-field_52-container\" class=\"wpforms-field wpforms-field-address\" data-field-id=\"52\"><label class=\"wpforms-field-label\">Address<\/label><div class=\"wpforms-field-row wpforms-field-large\"><div ><input type=\"text\" id=\"wpforms-280-field_52\" class=\"wpforms-field-address-address1\" name=\"wpforms[fields][52][address1]\" ><label for=\"wpforms-280-field_52\" class=\"wpforms-field-sublabel after\">Address Line 1<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div ><input type=\"text\" id=\"wpforms-280-field_52-address2\" class=\"wpforms-field-address-address2\" name=\"wpforms[fields][52][address2]\" ><label for=\"wpforms-280-field_52-address2\" class=\"wpforms-field-sublabel after\">Address Line 2<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-280-field_52-city\" class=\"wpforms-field-address-city\" name=\"wpforms[fields][52][city]\" ><label for=\"wpforms-280-field_52-city\" class=\"wpforms-field-sublabel after\">City<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><select id=\"wpforms-280-field_52-state\" class=\"wpforms-field-address-state\" name=\"wpforms[fields][52][state]\" ><option class=\"placeholder\" value=\"\" selected disabled>Choose One ( Click Here )<\/option><option value=\"AL\" >Alabama<\/option><option value=\"AK\" >Alaska<\/option><option value=\"AZ\" >Arizona<\/option><option value=\"AR\" >Arkansas<\/option><option value=\"CA\" >California<\/option><option value=\"CO\" >Colorado<\/option><option value=\"CT\" >Connecticut<\/option><option value=\"DE\" >Delaware<\/option><option value=\"DC\" >District of Columbia<\/option><option value=\"FL\" >Florida<\/option><option value=\"GA\" >Georgia<\/option><option value=\"HI\" >Hawaii<\/option><option value=\"ID\" >Idaho<\/option><option value=\"IL\" >Illinois<\/option><option value=\"IN\" >Indiana<\/option><option value=\"IA\" >Iowa<\/option><option value=\"KS\" >Kansas<\/option><option value=\"KY\" >Kentucky<\/option><option value=\"LA\" >Louisiana<\/option><option value=\"ME\" >Maine<\/option><option value=\"MD\" >Maryland<\/option><option value=\"MA\" >Massachusetts<\/option><option value=\"MI\" >Michigan<\/option><option value=\"MN\" >Minnesota<\/option><option value=\"MS\" >Mississippi<\/option><option value=\"MO\" >Missouri<\/option><option value=\"MT\" >Montana<\/option><option value=\"NE\" >Nebraska<\/option><option value=\"NV\" >Nevada<\/option><option value=\"NH\" >New Hampshire<\/option><option value=\"NJ\" >New Jersey<\/option><option value=\"NM\" >New Mexico<\/option><option value=\"NY\" >New York<\/option><option value=\"NC\" >North Carolina<\/option><option value=\"ND\" >North Dakota<\/option><option value=\"OH\" >Ohio<\/option><option value=\"OK\" >Oklahoma<\/option><option value=\"OR\" >Oregon<\/option><option value=\"PA\" >Pennsylvania<\/option><option value=\"RI\" >Rhode Island<\/option><option value=\"SC\" >South Carolina<\/option><option value=\"SD\" >South Dakota<\/option><option value=\"TN\" >Tennessee<\/option><option value=\"TX\" >Texas<\/option><option value=\"UT\" >Utah<\/option><option value=\"VT\" >Vermont<\/option><option value=\"VA\" >Virginia<\/option><option value=\"WA\" >Washington<\/option><option value=\"WV\" >West Virginia<\/option><option value=\"WI\" >Wisconsin<\/option><option value=\"WY\" >Wyoming<\/option><\/select><label for=\"wpforms-280-field_52-state\" class=\"wpforms-field-sublabel after\">State<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-280-field_52-postal\" class=\"wpforms-field-address-postal wpforms-masked-input\" data-inputmask-mask=\"(99999)|(99999-9999)\" data-inputmask-keepstatic=\"true\" data-rule-inputmask-incomplete=\"1\" name=\"wpforms[fields][52][postal]\" ><label for=\"wpforms-280-field_52-postal\" class=\"wpforms-field-sublabel after\">Zip Code<\/label><\/div><\/div><\/div><div id=\"wpforms-280-field_107-container\" class=\"wpforms-field wpforms-field-html\" data-field-id=\"107\"><div id=\"wpforms-280-field_107\">Due to current privacy regulations, the One Wish Foundation requires the parent's \/ legal guardian\u2019s permission to contact your child\u2019s physician. Please sign below if you agree with the following statement: I hereby grant the One Wish Foundation permission to contact my child\u2019s attending physician regarding my child\u2019s medical condition. I further grant permission for the physician, listed above, to release the required information and\/or speak to the One Wish Foundation regarding my child\u2019s medical condition. If your child has more than one primary physician - please include information on an additional sheet.<\/div><\/div><div id=\"wpforms-280-field_56-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half wpforms-first\" data-field-id=\"56\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_56\">Signature of Parent or Guardian ( Type in Name )<\/label><input type=\"text\" id=\"wpforms-280-field_56\" class=\"wpforms-field-large\" name=\"wpforms[fields][56]\" ><\/div><div id=\"wpforms-280-field_57-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half\" data-field-id=\"57\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_57\">Date<\/label><input type=\"text\" id=\"wpforms-280-field_57\" class=\"wpforms-field-large\" name=\"wpforms[fields][57]\" ><\/div><div id=\"wpforms-280-field_104-container\" class=\"wpforms-field wpforms-field-html\" data-field-id=\"104\"><div id=\"wpforms-280-field_104\"><br \/>\r\n<br \/>\r\n<hr \/><\/div><\/div><div id=\"wpforms-280-field_58-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"58\"><h3 id=\"wpforms-280-field_58\">PARENT\/GUARDIAN CONTACT INFORMATION<\/h3><\/div><div id=\"wpforms-280-field_59-container\" class=\"wpforms-field wpforms-field-text wpforms-one-third wpforms-first\" data-field-id=\"59\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_59\">PARENT\/GUARDIAN CONTACT INFORMATION: Fathers Name<\/label><input type=\"text\" id=\"wpforms-280-field_59\" class=\"wpforms-field-large\" name=\"wpforms[fields][59]\" ><\/div><div id=\"wpforms-280-field_60-container\" class=\"wpforms-field wpforms-field-text wpforms-one-third\" data-field-id=\"60\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_60\">Home \/ Cell # (Primary)<\/label><input type=\"text\" id=\"wpforms-280-field_60\" class=\"wpforms-field-large\" name=\"wpforms[fields][60]\" ><\/div><div id=\"wpforms-280-field_61-container\" class=\"wpforms-field wpforms-field-text wpforms-one-third\" data-field-id=\"61\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_61\">Work #<\/label><input type=\"text\" id=\"wpforms-280-field_61\" class=\"wpforms-field-large\" name=\"wpforms[fields][61]\" ><\/div><div id=\"wpforms-280-field_62-container\" class=\"wpforms-field wpforms-field-address\" data-field-id=\"62\"><label class=\"wpforms-field-label\">Address<\/label><div class=\"wpforms-field-row wpforms-field-large\"><div ><input type=\"text\" id=\"wpforms-280-field_62\" class=\"wpforms-field-address-address1\" name=\"wpforms[fields][62][address1]\" ><label for=\"wpforms-280-field_62\" class=\"wpforms-field-sublabel after\">Address Line 1<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div ><input type=\"text\" id=\"wpforms-280-field_62-address2\" class=\"wpforms-field-address-address2\" name=\"wpforms[fields][62][address2]\" ><label for=\"wpforms-280-field_62-address2\" class=\"wpforms-field-sublabel after\">Address Line 2<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-280-field_62-city\" class=\"wpforms-field-address-city\" name=\"wpforms[fields][62][city]\" ><label for=\"wpforms-280-field_62-city\" class=\"wpforms-field-sublabel after\">City<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><select id=\"wpforms-280-field_62-state\" class=\"wpforms-field-address-state\" name=\"wpforms[fields][62][state]\" ><option class=\"placeholder\" value=\"\" selected disabled>Choose One ( Click Here )<\/option><option value=\"AL\" >Alabama<\/option><option value=\"AK\" >Alaska<\/option><option value=\"AZ\" >Arizona<\/option><option value=\"AR\" >Arkansas<\/option><option value=\"CA\" >California<\/option><option value=\"CO\" >Colorado<\/option><option value=\"CT\" >Connecticut<\/option><option value=\"DE\" >Delaware<\/option><option value=\"DC\" >District of Columbia<\/option><option value=\"FL\" >Florida<\/option><option value=\"GA\" >Georgia<\/option><option value=\"HI\" >Hawaii<\/option><option value=\"ID\" >Idaho<\/option><option value=\"IL\" >Illinois<\/option><option value=\"IN\" >Indiana<\/option><option value=\"IA\" >Iowa<\/option><option value=\"KS\" >Kansas<\/option><option value=\"KY\" >Kentucky<\/option><option value=\"LA\" >Louisiana<\/option><option value=\"ME\" >Maine<\/option><option value=\"MD\" >Maryland<\/option><option value=\"MA\" >Massachusetts<\/option><option value=\"MI\" >Michigan<\/option><option value=\"MN\" >Minnesota<\/option><option value=\"MS\" >Mississippi<\/option><option value=\"MO\" >Missouri<\/option><option value=\"MT\" >Montana<\/option><option value=\"NE\" >Nebraska<\/option><option value=\"NV\" >Nevada<\/option><option value=\"NH\" >New Hampshire<\/option><option value=\"NJ\" >New Jersey<\/option><option value=\"NM\" >New Mexico<\/option><option value=\"NY\" >New York<\/option><option value=\"NC\" >North Carolina<\/option><option value=\"ND\" >North Dakota<\/option><option value=\"OH\" >Ohio<\/option><option value=\"OK\" >Oklahoma<\/option><option value=\"OR\" >Oregon<\/option><option value=\"PA\" >Pennsylvania<\/option><option value=\"RI\" >Rhode Island<\/option><option value=\"SC\" >South Carolina<\/option><option value=\"SD\" >South Dakota<\/option><option value=\"TN\" >Tennessee<\/option><option value=\"TX\" >Texas<\/option><option value=\"UT\" >Utah<\/option><option value=\"VT\" >Vermont<\/option><option value=\"VA\" >Virginia<\/option><option value=\"WA\" >Washington<\/option><option value=\"WV\" >West Virginia<\/option><option value=\"WI\" >Wisconsin<\/option><option value=\"WY\" >Wyoming<\/option><\/select><label for=\"wpforms-280-field_62-state\" class=\"wpforms-field-sublabel after\">State<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-280-field_62-postal\" class=\"wpforms-field-address-postal wpforms-masked-input\" data-inputmask-mask=\"(99999)|(99999-9999)\" data-inputmask-keepstatic=\"true\" data-rule-inputmask-incomplete=\"1\" name=\"wpforms[fields][62][postal]\" ><label for=\"wpforms-280-field_62-postal\" class=\"wpforms-field-sublabel after\">Zip Code<\/label><\/div><\/div><\/div><div id=\"wpforms-280-field_63-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half wpforms-first\" data-field-id=\"63\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_63\">E-mail<\/label><input type=\"text\" id=\"wpforms-280-field_63\" class=\"wpforms-field-large\" name=\"wpforms[fields][63]\" ><\/div><div id=\"wpforms-280-field_64-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half\" data-field-id=\"64\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_64\">Fax #<\/label><input type=\"text\" id=\"wpforms-280-field_64\" class=\"wpforms-field-large\" name=\"wpforms[fields][64]\" ><\/div><div id=\"wpforms-280-field_65-container\" class=\"wpforms-field wpforms-field-text wpforms-one-third wpforms-first\" data-field-id=\"65\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_65\">Mothers Name<\/label><input type=\"text\" id=\"wpforms-280-field_65\" class=\"wpforms-field-large\" name=\"wpforms[fields][65]\" ><\/div><div id=\"wpforms-280-field_66-container\" class=\"wpforms-field wpforms-field-text wpforms-one-third\" data-field-id=\"66\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_66\">Home \/ Cell # (Primary)<\/label><input type=\"text\" id=\"wpforms-280-field_66\" class=\"wpforms-field-large\" name=\"wpforms[fields][66]\" ><\/div><div id=\"wpforms-280-field_67-container\" class=\"wpforms-field wpforms-field-text wpforms-one-third\" data-field-id=\"67\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_67\">Work #<\/label><input type=\"text\" id=\"wpforms-280-field_67\" class=\"wpforms-field-large\" name=\"wpforms[fields][67]\" ><\/div><div id=\"wpforms-280-field_68-container\" class=\"wpforms-field wpforms-field-address\" data-field-id=\"68\"><label class=\"wpforms-field-label\">Address<\/label><div class=\"wpforms-field-row wpforms-field-large\"><div ><input type=\"text\" id=\"wpforms-280-field_68\" class=\"wpforms-field-address-address1\" name=\"wpforms[fields][68][address1]\" ><label for=\"wpforms-280-field_68\" class=\"wpforms-field-sublabel after\">Address Line 1<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div ><input type=\"text\" id=\"wpforms-280-field_68-address2\" class=\"wpforms-field-address-address2\" name=\"wpforms[fields][68][address2]\" ><label for=\"wpforms-280-field_68-address2\" class=\"wpforms-field-sublabel after\">Address Line 2<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-280-field_68-city\" class=\"wpforms-field-address-city\" name=\"wpforms[fields][68][city]\" ><label for=\"wpforms-280-field_68-city\" class=\"wpforms-field-sublabel after\">City<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><select id=\"wpforms-280-field_68-state\" class=\"wpforms-field-address-state\" name=\"wpforms[fields][68][state]\" ><option class=\"placeholder\" value=\"\" selected disabled>Choose One ( Click Here )<\/option><option value=\"AL\" >Alabama<\/option><option value=\"AK\" >Alaska<\/option><option value=\"AZ\" >Arizona<\/option><option value=\"AR\" >Arkansas<\/option><option value=\"CA\" >California<\/option><option value=\"CO\" >Colorado<\/option><option value=\"CT\" >Connecticut<\/option><option value=\"DE\" >Delaware<\/option><option value=\"DC\" >District of Columbia<\/option><option value=\"FL\" >Florida<\/option><option value=\"GA\" >Georgia<\/option><option value=\"HI\" >Hawaii<\/option><option value=\"ID\" >Idaho<\/option><option value=\"IL\" >Illinois<\/option><option value=\"IN\" >Indiana<\/option><option value=\"IA\" >Iowa<\/option><option value=\"KS\" >Kansas<\/option><option value=\"KY\" >Kentucky<\/option><option value=\"LA\" >Louisiana<\/option><option value=\"ME\" >Maine<\/option><option value=\"MD\" >Maryland<\/option><option value=\"MA\" >Massachusetts<\/option><option value=\"MI\" >Michigan<\/option><option value=\"MN\" >Minnesota<\/option><option value=\"MS\" >Mississippi<\/option><option value=\"MO\" >Missouri<\/option><option value=\"MT\" >Montana<\/option><option value=\"NE\" >Nebraska<\/option><option value=\"NV\" >Nevada<\/option><option value=\"NH\" >New Hampshire<\/option><option value=\"NJ\" >New Jersey<\/option><option value=\"NM\" >New Mexico<\/option><option value=\"NY\" >New York<\/option><option value=\"NC\" >North Carolina<\/option><option value=\"ND\" >North Dakota<\/option><option value=\"OH\" >Ohio<\/option><option value=\"OK\" >Oklahoma<\/option><option value=\"OR\" >Oregon<\/option><option value=\"PA\" >Pennsylvania<\/option><option value=\"RI\" >Rhode Island<\/option><option value=\"SC\" >South Carolina<\/option><option value=\"SD\" >South Dakota<\/option><option value=\"TN\" >Tennessee<\/option><option value=\"TX\" >Texas<\/option><option value=\"UT\" >Utah<\/option><option value=\"VT\" >Vermont<\/option><option value=\"VA\" >Virginia<\/option><option value=\"WA\" >Washington<\/option><option value=\"WV\" >West Virginia<\/option><option value=\"WI\" >Wisconsin<\/option><option value=\"WY\" >Wyoming<\/option><\/select><label for=\"wpforms-280-field_68-state\" class=\"wpforms-field-sublabel after\">State<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-280-field_68-postal\" class=\"wpforms-field-address-postal wpforms-masked-input\" data-inputmask-mask=\"(99999)|(99999-9999)\" data-inputmask-keepstatic=\"true\" data-rule-inputmask-incomplete=\"1\" name=\"wpforms[fields][68][postal]\" ><label for=\"wpforms-280-field_68-postal\" class=\"wpforms-field-sublabel after\">Zip Code<\/label><\/div><\/div><\/div><div id=\"wpforms-280-field_74-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half wpforms-first\" data-field-id=\"74\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_74\">E-mail<\/label><input type=\"text\" id=\"wpforms-280-field_74\" class=\"wpforms-field-large\" name=\"wpforms[fields][74]\" ><\/div><div id=\"wpforms-280-field_75-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half\" data-field-id=\"75\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_75\">Fax #<\/label><input type=\"text\" id=\"wpforms-280-field_75\" class=\"wpforms-field-large\" name=\"wpforms[fields][75]\" ><\/div><div id=\"wpforms-280-field_70-container\" class=\"wpforms-field wpforms-field-html\" data-field-id=\"70\"><div id=\"wpforms-280-field_70\">Legal Guardian\u2019s Information \u2013 if not parents<\/div><\/div><div id=\"wpforms-280-field_69-container\" class=\"wpforms-field wpforms-field-text wpforms-one-third wpforms-first\" data-field-id=\"69\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_69\">Name<\/label><input type=\"text\" id=\"wpforms-280-field_69\" class=\"wpforms-field-large\" name=\"wpforms[fields][69]\" ><\/div><div id=\"wpforms-280-field_71-container\" class=\"wpforms-field wpforms-field-text wpforms-one-third\" data-field-id=\"71\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_71\">Home \/ Cell # (Primary)<\/label><input type=\"text\" id=\"wpforms-280-field_71\" class=\"wpforms-field-large\" name=\"wpforms[fields][71]\" ><\/div><div id=\"wpforms-280-field_72-container\" class=\"wpforms-field wpforms-field-text wpforms-one-third\" data-field-id=\"72\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_72\">Work #<\/label><input type=\"text\" id=\"wpforms-280-field_72\" class=\"wpforms-field-large\" name=\"wpforms[fields][72]\" ><\/div><div id=\"wpforms-280-field_73-container\" class=\"wpforms-field wpforms-field-address\" data-field-id=\"73\"><label class=\"wpforms-field-label\">Address<\/label><div class=\"wpforms-field-row wpforms-field-large\"><div ><input type=\"text\" id=\"wpforms-280-field_73\" class=\"wpforms-field-address-address1\" name=\"wpforms[fields][73][address1]\" ><label for=\"wpforms-280-field_73\" class=\"wpforms-field-sublabel after\">Address Line 1<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div ><input type=\"text\" id=\"wpforms-280-field_73-address2\" class=\"wpforms-field-address-address2\" name=\"wpforms[fields][73][address2]\" ><label for=\"wpforms-280-field_73-address2\" class=\"wpforms-field-sublabel after\">Address Line 2<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-280-field_73-city\" class=\"wpforms-field-address-city\" name=\"wpforms[fields][73][city]\" ><label for=\"wpforms-280-field_73-city\" class=\"wpforms-field-sublabel after\">City<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><select id=\"wpforms-280-field_73-state\" class=\"wpforms-field-address-state\" name=\"wpforms[fields][73][state]\" ><option class=\"placeholder\" value=\"\" selected disabled>Choose One ( Click Here )<\/option><option value=\"AL\" >Alabama<\/option><option value=\"AK\" >Alaska<\/option><option value=\"AZ\" >Arizona<\/option><option value=\"AR\" >Arkansas<\/option><option value=\"CA\" >California<\/option><option value=\"CO\" >Colorado<\/option><option value=\"CT\" >Connecticut<\/option><option value=\"DE\" >Delaware<\/option><option value=\"DC\" >District of Columbia<\/option><option value=\"FL\" >Florida<\/option><option value=\"GA\" >Georgia<\/option><option value=\"HI\" >Hawaii<\/option><option value=\"ID\" >Idaho<\/option><option value=\"IL\" >Illinois<\/option><option value=\"IN\" >Indiana<\/option><option value=\"IA\" >Iowa<\/option><option value=\"KS\" >Kansas<\/option><option value=\"KY\" >Kentucky<\/option><option value=\"LA\" >Louisiana<\/option><option value=\"ME\" >Maine<\/option><option value=\"MD\" >Maryland<\/option><option value=\"MA\" >Massachusetts<\/option><option value=\"MI\" >Michigan<\/option><option value=\"MN\" >Minnesota<\/option><option value=\"MS\" >Mississippi<\/option><option value=\"MO\" >Missouri<\/option><option value=\"MT\" >Montana<\/option><option value=\"NE\" >Nebraska<\/option><option value=\"NV\" >Nevada<\/option><option value=\"NH\" >New Hampshire<\/option><option value=\"NJ\" >New Jersey<\/option><option value=\"NM\" >New Mexico<\/option><option value=\"NY\" >New York<\/option><option value=\"NC\" >North Carolina<\/option><option value=\"ND\" >North Dakota<\/option><option value=\"OH\" >Ohio<\/option><option value=\"OK\" >Oklahoma<\/option><option value=\"OR\" >Oregon<\/option><option value=\"PA\" >Pennsylvania<\/option><option value=\"RI\" >Rhode Island<\/option><option value=\"SC\" >South Carolina<\/option><option value=\"SD\" >South Dakota<\/option><option value=\"TN\" >Tennessee<\/option><option value=\"TX\" >Texas<\/option><option value=\"UT\" >Utah<\/option><option value=\"VT\" >Vermont<\/option><option value=\"VA\" >Virginia<\/option><option value=\"WA\" >Washington<\/option><option value=\"WV\" >West Virginia<\/option><option value=\"WI\" >Wisconsin<\/option><option value=\"WY\" >Wyoming<\/option><\/select><label for=\"wpforms-280-field_73-state\" class=\"wpforms-field-sublabel after\">State<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-280-field_73-postal\" class=\"wpforms-field-address-postal wpforms-masked-input\" data-inputmask-mask=\"(99999)|(99999-9999)\" data-inputmask-keepstatic=\"true\" data-rule-inputmask-incomplete=\"1\" name=\"wpforms[fields][73][postal]\" ><label for=\"wpforms-280-field_73-postal\" class=\"wpforms-field-sublabel after\">Zip Code<\/label><\/div><\/div><\/div><div id=\"wpforms-280-field_76-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half wpforms-first\" data-field-id=\"76\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_76\">E-mail<\/label><input type=\"text\" id=\"wpforms-280-field_76\" class=\"wpforms-field-large\" name=\"wpforms[fields][76]\" ><\/div><div id=\"wpforms-280-field_77-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half\" data-field-id=\"77\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_77\">Fax #<\/label><input type=\"text\" id=\"wpforms-280-field_77\" class=\"wpforms-field-large\" name=\"wpforms[fields][77]\" ><\/div><div id=\"wpforms-280-field_79-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"79\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_79\">List full names of siblings and ages that are living at same household as applicant:<\/label><textarea id=\"wpforms-280-field_79\" class=\"wpforms-field-medium\" name=\"wpforms[fields][79]\" ><\/textarea><\/div><div id=\"wpforms-280-field_80-container\" class=\"wpforms-field wpforms-field-select wpforms-one-half wpforms-first wpforms-field-select-style-classic\" data-field-id=\"80\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_80\">If parents are divorced or separated \u2013 which parent does the child live with? <\/label><select id=\"wpforms-280-field_80\" class=\"wpforms-field-large\" name=\"wpforms[fields][80]\"><option value=\"Choose One ( Click Here )\"  class=\"choice-1 depth-1\"  >Choose One ( Click Here )<\/option><option value=\"Father\"  class=\"choice-2 depth-1\"  >Father<\/option><option value=\"Mother\"  class=\"choice-3 depth-1\"  >Mother<\/option><\/select><\/div><div id=\"wpforms-280-field_81-container\" class=\"wpforms-field wpforms-field-select wpforms-one-half wpforms-field-select-style-classic\" data-field-id=\"81\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_81\">Does this parent have legal custody of the child?<\/label><select id=\"wpforms-280-field_81\" class=\"wpforms-field-large\" name=\"wpforms[fields][81]\"><option value=\"Choose One ( Click Here )\"  class=\"choice-1 depth-1\"  >Choose One ( Click Here )<\/option><option value=\"Yes\"  class=\"choice-2 depth-1\"  >Yes<\/option><option value=\"No\"  class=\"choice-3 depth-1\"  >No<\/option><\/select><\/div><div id=\"wpforms-280-field_82-container\" class=\"wpforms-field wpforms-field-textarea wpforms-one-half wpforms-first\" data-field-id=\"82\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_82\">If child lives with legal guardian \u2013 please explain relationship:<\/label><textarea id=\"wpforms-280-field_82\" class=\"wpforms-field-medium\" name=\"wpforms[fields][82]\" ><\/textarea><\/div><div id=\"wpforms-280-field_83-container\" class=\"wpforms-field wpforms-field-textarea wpforms-one-half\" data-field-id=\"83\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_83\">Additional Contact(s) \u2013 in case we are unable to reach you:<\/label><textarea id=\"wpforms-280-field_83\" class=\"wpforms-field-medium\" name=\"wpforms[fields][83]\" ><\/textarea><\/div><div id=\"wpforms-280-field_106-container\" class=\"wpforms-field wpforms-field-html\" data-field-id=\"106\"><div id=\"wpforms-280-field_106\"><br \/>\r\n<br \/>\r\n<hr \/><\/div><\/div><div id=\"wpforms-280-field_91-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"91\"><h3 id=\"wpforms-280-field_91\">PARTICIPATION WAIVERS<\/h3><\/div><div id=\"wpforms-280-field_86-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"86\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_86\">PARTICIPATION WAIVERS: If the child is approved for a One Wish Foundation \u201cOne Wish Outdoor Adventure\u201d will the parents \/ guardian be willing to sign a Waiver of Liability? (If Yes \u2013 a copy of the Waiver of Liability will be sent to you for the proper signatures.)<\/label><select id=\"wpforms-280-field_86\" class=\"wpforms-field-medium\" name=\"wpforms[fields][86]\"><option value=\"Choose One ( Click Here )\"  class=\"choice-1 depth-1\"  >Choose One ( Click Here )<\/option><option value=\"Yes\"  class=\"choice-2 depth-1\"  >Yes<\/option><option value=\"No\"  class=\"choice-3 depth-1\"  >No<\/option><\/select><\/div><div id=\"wpforms-280-field_87-container\" class=\"wpforms-field wpforms-field-html\" data-field-id=\"87\"><div id=\"wpforms-280-field_87\">Part of our vision is to provide a memory that lasts forever and the ability to help others. If your child is approved for a One Wish Foundation \u201cOne Wish Outdoor Adventure\u201d do we have your permission to take video footage of your child\u2019s adventure and story? We request this permission in order to preserve his\/her memory forever. You will receive a copy of your child\u2019s video, a copy of the video will be preserved on our website for all visitors to see, and we may even have the opportunity to air your child\u2019s story on national television. In our efforts to help others \u2013 your physicians description of your child\u2019s story may bring awareness to others who may be experiencing the same issues.<\/div><\/div><div id=\"wpforms-280-field_88-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"88\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_88\">Do you grant the One Wish Foundation permission to show your child\u2019s story on our website and\/or television?<\/label><select id=\"wpforms-280-field_88\" class=\"wpforms-field-medium\" name=\"wpforms[fields][88]\"><option value=\"Choose One ( Click Here )\"  class=\"choice-1 depth-1\"  >Choose One ( Click Here )<\/option><option value=\"Yes\"  class=\"choice-2 depth-1\"  >Yes<\/option><option value=\"No\"  class=\"choice-3 depth-1\"  >No<\/option><\/select><\/div><div id=\"wpforms-280-field_89-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half wpforms-first\" data-field-id=\"89\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_89\">Signature of Parent or Guardian ( Type in Name )<\/label><input type=\"text\" id=\"wpforms-280-field_89\" class=\"wpforms-field-large\" name=\"wpforms[fields][89]\" ><\/div><div id=\"wpforms-280-field_90-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half\" data-field-id=\"90\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_90\">Date<\/label><input type=\"text\" id=\"wpforms-280-field_90\" class=\"wpforms-field-large\" name=\"wpforms[fields][90]\" ><\/div><div id=\"wpforms-280-field_105-container\" class=\"wpforms-field wpforms-field-html\" data-field-id=\"105\"><div id=\"wpforms-280-field_105\"><br \/>\r\n<br \/>\r\n<hr \/><\/div><\/div><div id=\"wpforms-280-field_92-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"92\"><h3 id=\"wpforms-280-field_92\">INFORMATION ON INDIVIDUAL COMPLETING THIS FORM<\/h3><\/div><div id=\"wpforms-280-field_93-container\" class=\"wpforms-field wpforms-field-text wpforms-one-third wpforms-first\" data-field-id=\"93\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_93\">INFORMATION ON INDIVIDUAL COMPLETING THIS FORM: Name<\/label><input type=\"text\" id=\"wpforms-280-field_93\" class=\"wpforms-field-large\" name=\"wpforms[fields][93]\" ><\/div><div id=\"wpforms-280-field_95-container\" class=\"wpforms-field wpforms-field-text wpforms-one-third\" data-field-id=\"95\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_95\">Home \/ Cell # (Primary)<\/label><input type=\"text\" id=\"wpforms-280-field_95\" class=\"wpforms-field-large\" name=\"wpforms[fields][95]\" ><\/div><div id=\"wpforms-280-field_94-container\" class=\"wpforms-field wpforms-field-text wpforms-one-third\" data-field-id=\"94\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_94\">Work #<\/label><input type=\"text\" id=\"wpforms-280-field_94\" class=\"wpforms-field-large\" name=\"wpforms[fields][94]\" ><\/div><div id=\"wpforms-280-field_97-container\" class=\"wpforms-field wpforms-field-address\" data-field-id=\"97\"><label class=\"wpforms-field-label\">Address<\/label><div class=\"wpforms-field-row wpforms-field-large\"><div ><input type=\"text\" id=\"wpforms-280-field_97\" class=\"wpforms-field-address-address1\" name=\"wpforms[fields][97][address1]\" ><label for=\"wpforms-280-field_97\" class=\"wpforms-field-sublabel after\">Address Line 1<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div ><input type=\"text\" id=\"wpforms-280-field_97-address2\" class=\"wpforms-field-address-address2\" name=\"wpforms[fields][97][address2]\" ><label for=\"wpforms-280-field_97-address2\" class=\"wpforms-field-sublabel after\">Address Line 2<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-280-field_97-city\" class=\"wpforms-field-address-city\" name=\"wpforms[fields][97][city]\" ><label for=\"wpforms-280-field_97-city\" class=\"wpforms-field-sublabel after\">City<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><select id=\"wpforms-280-field_97-state\" class=\"wpforms-field-address-state\" name=\"wpforms[fields][97][state]\" ><option class=\"placeholder\" value=\"\" selected disabled>Choose One ( Click Here )<\/option><option value=\"AL\" >Alabama<\/option><option value=\"AK\" >Alaska<\/option><option value=\"AZ\" >Arizona<\/option><option value=\"AR\" >Arkansas<\/option><option value=\"CA\" >California<\/option><option value=\"CO\" >Colorado<\/option><option value=\"CT\" >Connecticut<\/option><option value=\"DE\" >Delaware<\/option><option value=\"DC\" >District of Columbia<\/option><option value=\"FL\" >Florida<\/option><option value=\"GA\" >Georgia<\/option><option value=\"HI\" >Hawaii<\/option><option value=\"ID\" >Idaho<\/option><option value=\"IL\" >Illinois<\/option><option value=\"IN\" >Indiana<\/option><option value=\"IA\" >Iowa<\/option><option value=\"KS\" >Kansas<\/option><option value=\"KY\" >Kentucky<\/option><option value=\"LA\" >Louisiana<\/option><option value=\"ME\" >Maine<\/option><option value=\"MD\" >Maryland<\/option><option value=\"MA\" >Massachusetts<\/option><option value=\"MI\" >Michigan<\/option><option value=\"MN\" >Minnesota<\/option><option value=\"MS\" >Mississippi<\/option><option value=\"MO\" >Missouri<\/option><option value=\"MT\" >Montana<\/option><option value=\"NE\" >Nebraska<\/option><option value=\"NV\" >Nevada<\/option><option value=\"NH\" >New Hampshire<\/option><option value=\"NJ\" >New Jersey<\/option><option value=\"NM\" >New Mexico<\/option><option value=\"NY\" >New York<\/option><option value=\"NC\" >North Carolina<\/option><option value=\"ND\" >North Dakota<\/option><option value=\"OH\" >Ohio<\/option><option value=\"OK\" >Oklahoma<\/option><option value=\"OR\" >Oregon<\/option><option value=\"PA\" >Pennsylvania<\/option><option value=\"RI\" >Rhode Island<\/option><option value=\"SC\" >South Carolina<\/option><option value=\"SD\" >South Dakota<\/option><option value=\"TN\" >Tennessee<\/option><option value=\"TX\" >Texas<\/option><option value=\"UT\" >Utah<\/option><option value=\"VT\" >Vermont<\/option><option value=\"VA\" >Virginia<\/option><option value=\"WA\" >Washington<\/option><option value=\"WV\" >West Virginia<\/option><option value=\"WI\" >Wisconsin<\/option><option value=\"WY\" >Wyoming<\/option><\/select><label for=\"wpforms-280-field_97-state\" class=\"wpforms-field-sublabel after\">State<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-280-field_97-postal\" class=\"wpforms-field-address-postal wpforms-masked-input\" data-inputmask-mask=\"(99999)|(99999-9999)\" data-inputmask-keepstatic=\"true\" data-rule-inputmask-incomplete=\"1\" name=\"wpforms[fields][97][postal]\" ><label for=\"wpforms-280-field_97-postal\" class=\"wpforms-field-sublabel after\">Zip Code<\/label><\/div><\/div><\/div><div id=\"wpforms-280-field_98-container\" class=\"wpforms-field wpforms-field-email wpforms-one-half wpforms-first\" data-field-id=\"98\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_98\">Email <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-280-field_98\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][98]\" spellcheck=\"false\" required><\/div><div id=\"wpforms-280-field_99-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half\" data-field-id=\"99\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_99\">Fax #<\/label><input type=\"text\" id=\"wpforms-280-field_99\" class=\"wpforms-field-large\" name=\"wpforms[fields][99]\" ><\/div><div id=\"wpforms-280-field_100-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"100\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_100\">Relationship to child<\/label><select id=\"wpforms-280-field_100\" class=\"wpforms-field-medium\" name=\"wpforms[fields][100]\"><option value=\"Choose One ( Click Here )\"  class=\"choice-1 depth-1\"  >Choose One ( Click Here )<\/option><option value=\"Child&#039;s Parent\"  class=\"choice-2 depth-1\"  >Child's Parent<\/option><option value=\"Legal Guardian\"  class=\"choice-3 depth-1\"  >Legal Guardian<\/option><option value=\"Family Member\"  class=\"choice-4 depth-1\"  >Family Member<\/option><option value=\"Friend of Family\"  class=\"choice-5 depth-1\"  >Friend of Family<\/option><option value=\"Social Worker\"  class=\"choice-6 depth-1\"  >Social Worker<\/option><option value=\"Specialist\"  class=\"choice-7 depth-1\"  >Specialist<\/option><option value=\"Child&#039;s Physician\"  class=\"choice-8 depth-1\"  >Child's Physician<\/option><\/select><\/div><div id=\"wpforms-280-field_101-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half wpforms-first\" data-field-id=\"101\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_101\">How did you hear about the One Wish Foundation?<\/label><input type=\"text\" id=\"wpforms-280-field_101\" class=\"wpforms-field-large\" name=\"wpforms[fields][101]\" ><\/div><div id=\"wpforms-280-field_102-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half\" data-field-id=\"102\"><label class=\"wpforms-field-label\" for=\"wpforms-280-field_102\">Date Application is submitted<\/label><input type=\"text\" id=\"wpforms-280-field_102\" class=\"wpforms-field-large\" name=\"wpforms[fields][102]\" ><\/div><div id=\"wpforms-280-field_103-container\" class=\"wpforms-field wpforms-field-html\" data-field-id=\"103\"><div id=\"wpforms-280-field_103\">If you have any questions &ndash; please contact:<br \/>\r\nJarrod Renninger<br \/>\r\nPresident &amp; Founder<br \/>\r\nE-mail: mrr803@comcast.net<br \/>\r\nE-mail: jarrod.renninger@onewishfoundation.org<br \/>\r\n<br \/>\r\nSpecial Note: Everyone at the One Wish Foundation would like to personally thank-you for taking the time to learn about our organization and submit an application to us. If we had &ldquo;one&rdquo; wish of our own it would be to grant every application that is submitted. Unfortunately, it is impossible for us to do that due to the limitations on donated funds, limited resources and amount of available time provided by our officers, board members, and volunteers.<br \/>\r\nWe give you our promise that your application will be given our full attention and that if you are selected you will be contacted within 90 days from the date the application was submitted. If you do not hear from us within 90 days we will keep your application on file for future election.<br \/>\r\nThank you for your understanding in this matter.<br \/><\/div><\/div><\/div><!-- .wpforms-field-container --><div class=\"wpforms-recaptcha-container wpforms-is-recaptcha wpforms-is-recaptcha-type-v2\" ><div class=\"g-recaptcha\" data-sitekey=\"6LfOMr8UAAAAACIhpvJFxMylMhPw1tZM1cCynN-t\"><\/div><input type=\"text\" name=\"g-recaptcha-hidden\" class=\"wpforms-recaptcha-hidden\" style=\"position:absolute!important;clip:rect(0,0,0,0)!important;height:1px!important;width:1px!important;border:0!important;overflow:hidden!important;padding:0!important;margin:0!important;\" data-rule-recaptcha=\"1\"><\/div><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"280\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/onewishfoundation.org\/owf\/wp-json\/wp\/v2\/pages\/274\"><input type=\"hidden\" name=\"url_referer\" value=\"\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-280\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\" aria-live=\"assertive\" value=\"wpforms-submit\">Submit<\/button><\/div><\/form><\/div>  <!-- .wpforms-container -->[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row full_width=&#8221;stretch_row&#8221; bg_type=&#8221;bg_color&#8221; css=&#8221;.vc_custom_1571878420218{margin-top: -70px !important;}&#8221; bg_color_value=&#8221;#def4d5&#8243;][vc_column][vc_column_text]Eligibility Requirements: Children ages 6-18 yrs., U.S. Citizen, with life-altering medical or social conditions, No previous grants for outdoor adventures. Depending on the individual wish \u2013 local sporting regulations will apply. Age exceptions may be made to accommodate injured U.S. military personnel\/veterans. Please fill out the application in it\u2019s&hellip;<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"ngg_post_thumbnail":0,"footnotes":""},"class_list":["post-274","page","type-page","status-publish","hentry","description-off"],"_links":{"self":[{"href":"https:\/\/onewishfoundation.org\/owf\/wp-json\/wp\/v2\/pages\/274","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/onewishfoundation.org\/owf\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/onewishfoundation.org\/owf\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/onewishfoundation.org\/owf\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/onewishfoundation.org\/owf\/wp-json\/wp\/v2\/comments?post=274"}],"version-history":[{"count":17,"href":"https:\/\/onewishfoundation.org\/owf\/wp-json\/wp\/v2\/pages\/274\/revisions"}],"predecessor-version":[{"id":629,"href":"https:\/\/onewishfoundation.org\/owf\/wp-json\/wp\/v2\/pages\/274\/revisions\/629"}],"wp:attachment":[{"href":"https:\/\/onewishfoundation.org\/owf\/wp-json\/wp\/v2\/media?parent=274"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}